The House : Catastrophic Illness

By a 302-177 vote, the House passed and sent to the Senate a bill (HR 2470) to protect about 31 million elderly and disabled Medicare patients against runaway costs for doctors, hospitals and drugs caused by lengthy illnesses.

Supplemental Medicare premiums of up to $580 a year initially, charged only to beneficiaries with enough means to file Internal Revenue Service tax returns, would finance the projected $33-billion, five-year cost of the new catastrophic coverage.

In early stages of the plan, people covered by Medicare each year would have to pay no more than $1,043 for “reasonable” doctors’ bills, $544 for hospital care and 20% of the tab for prescription drugs above a $500 deductible. The bill adds modest benefits for care at home, hospices and nursing homes.

Members voting yes supported the catastrophic illness bill.

How They Voted Yea Nay No vote Rep. Beilenson (D) x Rep. Berman (D) x Rep. Gallegly (R) x Rep. Moorhead (R) x Rep. Waxman (D) x

GOP Substitute

The House rejected, 242 to 190, the Republican alternative to the catastrophic illness bill (above). Derived from the Reagan Administration’s proposal to protect the elderly against staggering medical expenses, the GOP substitute carried a price tag of $18.2 billion over five years.

In another key variation from the Democratic plan, it provided drug reimbursement only to the needy over 65 years of age. This was designed in part to ease fears in some quarters that AIDS patients on Medicare disability would drain the resources of the drug benefits program.

Supporter Jerry Lewis (R-Highland) said the high cost of the Democratic bill could “undermine the Medicare and Social Security systems.”

Opponent Henry Waxman (D-Los Angeles) said cost-conscious Republicans had produced a plan “that is certainly not generous to the elderly and disabled in this country.”

Members voting yes favored the GOP alternative.

How They Voted Yea Nay No vote Rep. Beilenson (D) x Rep. Berman (D) x Rep. Gallegly (R) x Rep. Moorhead (R) x Rep. Waxman (D) x

Generic Drugs

By a vote of 265 to 161, the House rejected an amendment making it easier for doctors to prescribe brand-name rather than generic drugs to Medicare patients under pending catastrophic illness legislation (above).

The vote left intact a requirement that doctors write out brand-name requests. The rejected amendment enabled doctors to specify brand-name drugs merely by checking a box on the prescription form.

Sponsor Andrew Jacobs Jr. (D-Ind.) said the issue was whether “somebody in Washington or somebody who has a stethoscope on the chest at the time” should decide between the two.

Opponent Ron Wyden (D-Ore.) said, “We certainly should not be setting up . . . new obstacles to using generic drugs.”

Members voting yes wanted to facilitate the prescription of brand-name drugs under Medicare.

How They Voted Yea Nay No vote Rep. Beilenson (D) x Rep. Berman (D) x Rep. Gallegly (R) x Rep. Moorhead (R) x Rep. Waxman (D) x